Parent-Mediated Targeted Intervention for Young Children At-Risk for Autism Spectrum Disorder

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Given that screeners can now detect markers of Autism Spectrum Disorder (ASD) as early as six to nine months of age, conducting pre-diagnostic interventions for young children at risk for developing ASD is important to improve key developmental skills. Parents of three pre-diagnostic at-risk children (aged 19, 23 and 26 months old) first identified potential target problems on the Parent Observation of Early Markers Scale (POEMS, Feldman et al., 2012) that were confirmed in baseline observations. A multiple baseline design across parent and child behaviours was used to evaluate a parent-mediated behavioral intervention to increase targeted developmental skills (e.g. responding to name, pointing to request, motor imitation) and reduce ASD-like symptoms. Parents received individual training in their home one hour per week over M=19 weeks (range: 11 to 29 weeks) on teaching strategies incorporating applied behaviour analysis and natural teaching environment techniques. Parent training consisted of behavioural skills training (instructions, modeling, practice and feedback). Some trained child behaviors include the child responding to their name being called with eye contact, pointing to request and motor imitation. All parents and children improved skills that were maintained in a 4 or 8 week follow-up period. For the most part, child skills did not improve until parents reached 80% teaching fidelity. There was some evidence of child response generalization for untrained behaviors. Post-intervention, parents rated many targeted developmental skills as less concerning on the POEMS, suggesting that parents may be able to mitigate target developmental concerns in young children showing early symptoms of ASD.